Part D

Prescription Drug Plans

A Prescription Drug Plan, abbreviated PDP, is also known as Medicare Part D. Medicare Part D helps pay for your prescription drugs. A prescription drug plan is optional and available to anyone with Medicare Part A and/or Medicare Part B. To get Medicare drug coverage, you must join a Medicare-approved drug plan (stand-alone PDP) or a Medicare Advantage plan that includes drug coverage. 

Prescription Drug Plan Enrollment

Prescription Drug Plan Enrollment Periods

  • Initial Enrollment Period (IEP) - When you first become eligible for Medicare.

  • Annual Election Period (AEP) - October 15 - December 7During this time, you can enroll, drop or change your PDP plan; the plan will go into effect Jan. 1st.​

  • Special Enrollment Period (SEP) - You can enroll when certain circumstances apply, like if you move or leave group coverage. Rules for each SEP are different. 

Late Enrollment Penalty: If you decide not to enroll in a prescription plan when you're first eligible, and don't have other credible drug coverage, you'll likely pay a late enrollment penalty if you join a plan later. This penalty will be in force the remainder of the time you're in a Medicare drug plan. We highly recommend you enroll in a drug plan as soon as you're eligible, even if you don't take any prescriptions.

PLAN COSTS

For a Prescription Drug Plan, you can expect to make these payments throughout the year:

  • Monthly premium

  • Plan deductible

  • Drug copayments or coinsurance

  • Costs in the coverage gap

  • Costs if you receive Extra Help

  • The late enrollment penalty, if applicable

Prescription Drugs

DRUG COSTS

The actual costs of your prescriptions vary greatly and depend on numerous factors, like:

  • Whether or not your drug is on your plan's formulary

  • The tier your drug is in

  • Which drug benefit phase you're currently in

  • The pharmacy you use

  • If you receive Extra Help

MEDICARE DRUG PLAN COSTS

Finding the Best Prescription Drug Plan

Choosing the perfect drug plan depends on many factors. You have to take into consideration:

 

It's important to make sure all your drugs are covered as much as possible. Luckily, Medicare has made this process a bit easier. Medicare has created something called the Medicare Plan Finder. This website takes into consideration all these factors and automatically generates a list of plans, sorting them by the lowest annual out-of-pocket costs to you.

This is where having an agent can be a huge advantage! Using the government's Plan Finder, we can recommend the a prescription plan to fit your individual needs at the lowest cost to you!

  • The prescriptions you're currently taking

  • The dosage of each drug you're taking

  • The frequency you take each drug

  • If you take brand name or generic drugs

  • The county you live in

  • Your preferred pharmacy

  • Whether or not you use mail order